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69 Cards in this Set
- Front
- Back
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Dense granules of platelets contain what?
Alpha granules of platelets contain what? |
Dense - ADP, Ca
Alpha - vWF & fibrinogen |
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Basophilic granules contain what?
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Heparin
Histamine LTN D4 Other vasoactive amines |
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Mast cell granules contain what?
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Histamine, heparin, eosinophil chemotactic factors
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Eosinophil granules contain what?
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Histaminase
Arylsulfatase (deficient in metachromatic leukodystrophy) |
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DDx for Eosinophilia
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D - Drugs
N - Neoplasma A - Allergy, asthma, churg struass A -Addison's A- Acute interstitial nephritis C - Collagen Vascular disease P - Parasites - Ascaris (loffler's eosinophilia pneumonitis) |
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Acanthocytes are seen in....
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liver disease
abetalipoproteinemia They are irregularly spiked RBC |
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Basophilic stippling is in....
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T - Thalassemias
A - Anemia of chronic disease I - Iron deficiency L - LEAD POISONING They are fragments of denatured RNA because the enzyme that normally breaks them down is inhibited |
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Bite cells are seen in
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G6PD deficiency
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Macro-ovalocyte is seen in
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megaloblastic anemia, marrow failure
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Ringed sideroblasts are seen in
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Sideroblastic anemia
Lead poisoning Granules of Fe accumulate in perinuclear mitochondria |
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Dense granules of platelets contain what?
Alpha granules of platelets contain what? |
Dense - ADP, Ca
Alpha - vWF & fibrinogen |
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Basophilic granules contain what?
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Heparin
Histamine LTN D4 Other vasoactive amines |
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Mast cell granules contain what?
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Histamine, heparin, eosinophil chemotactic factors
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Eosinophil granules contain what?
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Histaminase
Arylsulfatase (deficient in metachromatic leukodystrophy) |
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DDx for Eosinophilia
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D - Drugs
N - Neoplasma A - Allergy, asthma, churg struass A -Addison's A- Acute interstitial nephritis C - Collagen Vascular disease P - Parasites - Ascaris (loffler's eosinophilia pneumonitis) |
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schistocytes are seen in?
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Due to MECHANICAL destruction
DIC (forced through fibrin network) TTP/HUS Traumatic hemolysis (prosthetic valves) |
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Spherocytes are what?
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Defect in spectrin or start losing parts of membrane as you pass through the spleen
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See teardrop cells in what?
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Marrow infiltration (e.g. myelofibrosis)
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Target cells are seen in?
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H - HbC disease
A - Asplenia L - Liver disease T - Thalassemias |
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How are Heinz bodies formed
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Oxidation of iron from ferrous(2+) to ferric (3+) leads to denatured Hb precipitation & damage to RBC membranes --> formation BITE CELLS
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basophilic nuclear remnants found in RBC's
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Howell-Jolly bodies
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when do you see howell jolly bodyies
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hyposplenia or asplenia
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what are nonmegaloblastic macrocytic anemias caused by?
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Liver disease
Alcoholism Reticulocytosis Metabolic d/o (orotic aciduria) 5FU, AZT, hydroxyurea |
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what are microcytic anemias?
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Fe deficiency
a & b thalassemias Sideroblastic anemia |
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causes of aplastic anemia
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Radiation & drugs (benzene, chloramphenicol, alkylating agents, antimetabolites
Viral agents - Parvo B19, EBV, HIV Fanconi's anemia (inherited defect in DNA repair) Idiopathic or follow acute hepatitis |
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Causes of hemolysis in G6PD deficient pts
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hemolysis IS PAIN
INH Sulfonamides Primaquine Aspirin Ibuprofen Nitrofurantoin Fava beans Dapsone |
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what type of cells do you see in a G6PD pt
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Bite cells, Heinz bodies (denatured Hb due to oxidation of Fe2 to Fe3)
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what are the anemias you see a crew cut apperance on skull xray due to marrow expansion from inc EPO
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Sickle cell & thalassemias
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what drug increases HbF?
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Hydroxyurea
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what is the ddx for increased epo?
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Renal cell ca
Hepatocellular Ca Pheochromacytoma Hemangioblastoma |
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what are the signs/sx of lead poisoning?
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LEAD
L-Lead lines/burton's lines on gingivae & epiphyses of long bones E-encephalopathy & erythocyte basophilic stippling A -Abdominal colic, anemia (sideroblastic) D - Drops (wrist & foot) |
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Rx for lead poisoning
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Dimercaprol & EDTA
Succimer for kids |
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what do platelet count & bleeding time look like in Bernard Soulier
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Defect in GpIb -- decreased platelet count, prolonged bleeding time
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Dec GPIIb/IIIa, no platelet clumping, prolonged bleeding time, no change in platelet count
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Glanzmenns thrombasthenia
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Anti-GPIIb/IIIa abs --> peripheral plate destruction --> dec PC, inc BT
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IZTP - Rx w/ IVIg, steroids, splenectomy
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dec platelet survival, def of ADAMTS 13 --> dec degradation of vWF multimers, inc platelet aggregation & thrombosis, schistocytes & LDH
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TTP
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Sx of TTP
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Pentoid of neuro & renal sx, fever, thrombocytopenia, & microangiopathic hemolytic anemia
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what does PT monitor
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I, II, V, VII, X
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PTT tests
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all factors BUT VII, XIII
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Inc BT & Inc PTT due to defect in platelet to collagen adhesion & coagulation defect
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vWF
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Causes of DIC
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STOP Making New Thrombi
Sepsis, Trauma, Obstetric, acute Pancreatitis, Malignancy, Nephrotic syndrome, Transfusion |
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what labs do you see in DIC
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Schistocytes, inc fibrin split products, dec fibrinogen, dec factors V & VIII
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MCC of inhereited hypercoaguability
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Factor V Leiden - prod of mutant factor V that ca't be degraded by protein C
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decreased ability to inactivate Factors V & VIII
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Protein C or S deficiency - inc risk of hemorrhagic skin necrosis following administration of warfarin
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T(8;14) TRANSLOCATION
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Burkitt's lymphoma - c-myc gene moves next to heavy chain Ig gene
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Most common adult non hodgkin lymphoma
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Diffuse Large B cell lymphoma - BCL 6
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t (11;14)
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Mantle Cell lymphoma - poor prognosis
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t(14;18)
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BCL-2 (inhibits apoptosis) --> Follicular lymphoma
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buzzwords for multiple myeloma
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M spike -
Fried egg apperance - monoclonal plasma cell Ig lt chains in urine - Bence Jones protein Rouleaux Hypercalcemia Renal insufficiency Anemia Bone/Back pain |
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waldenstrom's macroglobulinemia
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M spike = IgM --> hyperviscosity syndrome; no lytic bone lesions
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numerous blasts, pancytopenia, child, Tdt +, Pas +
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ALL
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Auer rods, CD13/33 +, median age 50, PAS (-)
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AML
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smudge cells, warm ab autoimmune hemolytic anemia
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CLL
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mature B cell tumor in elderly, stains TRAP
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Hairy cell leukemia - diffuse fried eggs, splenomegaly, pancytopenia
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what leukemia responds to all-trans retinoic acid?
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AML -M3 --> induces differentiation of myeloblasts
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t (9;2))
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bcr-abl - CML
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very low leukocyte alk phos, may transform to AML or ALL
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CML
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responds to imatinab
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CML
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median age of onset for ALL
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<15 yo
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median age of onset for AML
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~60 yo
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Median age of onset for CLL
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30-60
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Median age of onset for CML
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>60 yo (blast crisis - inc all cell lines)
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what is a leukemoid reaction
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inc WBC ct w/ left shift & an INCREASED alk phos
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peroxidase positive cytoplasmic inclusions in granulocytes & myeloblasts?
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Auer rods
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1. t(9;22)
2. t(8;14) 3. t(14; 18) 4. t(15;17) 5. t(11;22) 6. t(11;140 |
1. CML- bcr-abl
2. Burkitt's -cmyc 3. Follicular - bcl2 4.M3 -AML - responsive all-trans RA 5. Ewings sarcoma 6. Mantle cell lymphoma |
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proliferation d/o of dendrites from moncyte linearge. Defective cells express S-100, CD1a
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Langerhans cell histiocytosis (histiocytosis X)
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what drugs cause nephro & ototoxicity
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Loops
Vancomycin Cisplatin Aminoglycosides |
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what drugs interfere with microtubules
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Griseofulvin
Paclitaxel Vincristine/Vinblastine Antihelminthics (bendazoles) Colchicine |
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Side effects of steroids
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Cushing like sx
Immunosuppression Cataracts Acne Osteoporosis HTN Peptic ulcers Hyperglycemia Psychosis Insomnia |
